The New York Times

ADDICTION costs corporate America billions of dollars a year in lost productivity, absenteeism and higher health care expenses. It also derails many once-promising careers.

More companies are willing to offer assistance these days, especially as they deal with higher levels of employee stress from heightened workloads and job cuts. Yet many workers are still reluctant to take advantage of this help, for fear of jeopardizing their positions.

"Telling something so personal would have lessened my authority as a leader," said a 65-year-old executive of a computer company in Philadelphia who recently returned from 28 days of treatment for alcoholism. "As a manager, you have to create some distance between you and your employees." The executive, who spoke on condition of anonymity, had arranged for the treatment himself at the Caron Foundation, a rehabilitation center in Wernersville, Pa.

He says his job has been business as usual since his return last spring, but he acknowledged making up a story about his extended absence, which he even gave to his boss. "I told them I was overstressed and my doctor asked me to rest for a month," he said.

Professionals in similar situations have many delicate issues to navigate. How, for example, can they avoid being stigmatized by colleagues? And how can they explain gaps on a résumé after a long treatment period?

Many employees who receive treatment whether for alcoholism or for drug, gambling or food addictions will undoubtedly have some difficulties in the beginning, experts say, but as they recover, so too will their careers.

Abuse of some drugs has been climbing in the workplace. According to Quest Diagnostics, which provides workplace drug tests, the number of workers and job applicants who tested positive for amphetamine use rose 17 percent in 2002 from the previous year. At the Waismann Institute, in Beverly Hills, Calif., 60 percent of the patients, mostly high-powered business people, are addicted to painkillers like OxyContin and Vicodin, up from about 10 percent four years ago, according to Dr. Clifford A. Bernstein, the medical director there.

Given the weakness in the economy and the job market, none of this surprises Dr. Kenneth Siegel, a psychologist and president of the Impact Group, an executive leadership consulting firm in Beverly Hills. In the economic downturn of the late 1980's and early 1990's, he said, "Valium suddenly become the most prescribed drug in America." Similarly, today's workers are seeking ways to curb their anxieties and depression, he said.

One of the biggest difficulties is seeking help in the first place. Managers may be surrounded by underlings who are more than willing to help cover up the problem. A recent survey by the Caron Foundation of its patients found that 75 percent of executives in recovery said they had secretaries or assistants who went to great lengths to cover for them. Ninety percent said their peers had to work extra hours to compensate for their addiction.

Bruce Cotter, a recovering alcoholic, said that when he was a sales executive for major television networks on the East Coast during the 1980's, his assistants would routinely reschedule his appointments and even compile his sales reports. "I had a whole army of people who would mop up my messes," he said. Mr. Cotter now runs Bruce W. Cotter & Associates in Butler, Md., which intervenes on behalf of companies to provide treatment for addicted executives.

Another issue is confidentiality. Many workers, particularly executives, hesitate to seek help through their company's employee assistance programs or human resources departments, out of fear of looking weak or even harming the company's reputation.

"They feel that their company doesn't need to have the burden of knowing their top V.P., or C.E.O., is having a problem," said Dr. Scott C. Stacy, clinical program director for the Professional Renewal Center in Lawrence, Kan., which treats executives for substance and behavioral problems, including gambling and sexual addiction.

To help make executives feel more comfortable about seeking help, some companies are offering programs that promise heightened confidentiality, according to Dr. Richard A. Chaifetz, chief executive of the ComPsych Corporation in Chicago. Com- Psych provides employee assistance programs to companies like General Electric, American Express and Sprint. Meanwhile, Resources for Living in Austin, Tex., whose clients include Wal-Mart and Bridgestone, has a substance-abuse counseling program that can be completed entirely by phone.

William P. Schurgin, a partner at the Seyfarth Shaw law firm in Chicago, says employers are generally under no obligation to keep workers with untreated substance-abuse problems on the payroll. The Americans With Disabilities Act, he noted, does not protect these employees. But he added that employers were much more likely to support those who request help rather than those whose problems were discovered through drug testing or other means. "Most companies are going to give you a second chance," he said.

After seeking help, patients should avoid trying to keep up workloads during treatment.

"That's not the time to focus on work," said Dennis Henning, a consultant in Camarillo, Calif. who helps addicted lawyers and executives in the entertainment industry receive help through an intervention program. Mr. Henning, who is himself recovering from an eating disorder, said he recently worked with a lawyer who would have co-workers sneak in work for him to do.

MR. COTTER said that he, too, had confiscated executives' cellphones and laptops after they entered a treatment center. "These people want to keep their careers on track, and so they don't feel like they can take a moment out for themselves," he said. "But I have to convince them that if they don't get help, their career not to mention their lives might end up in the toilet."

Career experts also warn against trying to do too much soon after returning to work.

"A lot of executives who return to work are so fearful of losing their jobs, especially in this economy, that they step up the pace of their work and don't take vacations, or even lunch breaks," said Ruth Luban, a psychotherapist based in Santa Monica, Calif. She suggests easing back into the workload, perhaps even working part time for a few weeks if possible. Once the person is back to a full-time schedule, he should set boundaries on the job, by taking time out for lunch each day, for example, she said.

Reduced work schedules or even lunch breaks are not always possible for those who are feeling the pressure of work. Ms. Luban said she was working with a lawyer who recently was treated for a drug addiction and was about to return to work at a company that was merging with another concern. "There's only so much slack they can give him," she said.

She advised him to carve out tiny, regular portions in each day, so that he could "at least take a few deep breaths" without his bosses noticing.

IT'S up to the employee to decide whether to explain an absence for treatment to curious colleagues, said Liz Ryan, a human resources consultant in Boulder, Colo. Like the computer company executive from Pennsylvania who was treated for alcoholism, many of her clients chalk up the absence to an unspecified illness. But in some instances, she said, a recovering addict may need the support of a few trusted co-workers.

She said she recently worked with a salesman, a recovering alcoholic, whose boss had kept pressuring him to have a few beers with clients at late-night gatherings.

"He would really egg him on," she said. "Finally, the salesman had to clue in his boss, who was very understanding. If a boss or co-workers aren't supportive, by all means, look for a new opportunity."

In some cases, of course, colleagues may know about a worker's problem before treatment is sought. Ms. Ryan once worked with a young woman who returned from a work outing so intoxicated that she passed out in the office in front of several employees. Shortly thereafter, she entered an alcohol recovery program. When she returned, Ms. Ryan recommended that she simply acknowledge to co-workers that she had dealt with the problem and was ready to move on.

"People have short attention spans," she said. "Once they see you're back and you're doing a good job, they'll lose interest."

Experts recommend that recovering addicts seek out support groups set up exclusively for executives or certain professionals. The groups can help deal with worries about attendance at cocktail parties, for example, or other networking events.

Other career concerns can be addressed in the groups. The Pennsylvania executive said he was involved in a therapy group made up of high-level executives. For three one-hour sessions a week, the members talked about how their careers had contributed to their addiction problems and gave one another tips on eliminating some of the biggest stresses from their jobs.

"All of a sudden, I felt like I wasn't alone anymore," he said.

Career experts recommend that job seekers not disclose past addiction problems to prospective employers in an interview. "Let's be realistic there's still somewhat of a stigma to saying that you're an addict," Ms. Ryan said.

She advises job seekers to carefully develop a speech that explains any résumé gaps, and to practice it repeatedly. "Be prepared to say something like, `I was resolving some health issues,' or `I was doing some personal development work,' " she said.

"Most hiring managers won't bat an eyelash at a three- or even six-month gap, especially in this economy."